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Home My Public Portal About9641 VAL ST_Plumbing__ b�Aw•RA •. R CEO L•)(NCv enu �lJL 0 L�L'•'� ms APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE( BUILDING E V AL ST NUMBER FIXTURE OR ITEM • FEE ADOR �FvL ' WATER CLOSET Etio LOCALITY gITYI.EU NEAREST BATH TUB CROSSSTSHOWER OWNER SAMUEL /YL,IGLUYAAJ LAVATORY MAIL ALDIIL 57 VgL S SINK CITY LE C1 TEL NO µ45-4p5 DISHWASHER CONTRACTOR OlLuNem CLOTHES WASHER �6 ADDRESS SWIMMING POOL RECEPTOR CITY TEL NO LAWN SPRINKLER SYSTEM STATE LIC WATER HEATH LICENSE NO CLASS GAS SYSTEM 2 OUTLETS oo APPROVALS DATE INSPECTOR S SIGNATURE pL�i ET$OVER UNDER SLAB WORK ,�J•.� 5 PER SYSTEM ROUGH PLUMBING y7l QjL (Ifle — 4z Ail 6 D GAS PIPING O GAS VENT, HOT WATER HEATER Q PLUMBING FIXTURES C_R G GAS TEST $g�1 Plan check fee UTILITY CO NOTIFIED Z PLUMBING PERMIT ISSUING FEE E CIO TOTAL FEE FINAL -e-' Pion Check applicant CVA IDATION Nome ovyc, 6W Mst /7#f— (?OD--- Addrea � /!�-7a�v' �'- ,� L-6 9 8 9 A City Tel No # e o o e 5 XfI1fBY ALNXOWLEOGf THAT I(AVE READ THIS AIILICATION AND STATE - THAT THE ABOVE V CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES 2 - 2800 AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION o I HEREBY CERTIFY THAT I AY PROPERLY REOISTEREO AND/ORI LICENSED AS e . e 2 U O O 5 REM IRED BY LOS ANGELES COUNTY AND STATE Of CALRORNM OR THAT I AY THE LES OWNER OF AND I ND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTML 1 ^ O 2 Em SIGNATURE u OF PERMITTEE DIST ED INDUSTRIAL WASTE APPROVAL TSAsff 'n 5mo m APPLICATION FOR PERMIT I5EPARTMENT OF BUEMING AND SAFETY PLUMBING COUNTY OF LOS ANGELES WILLIAM J FOX CHIEF ENGINEER FOR APPLICANT TO FILL IN DIST C NO GROUP ZONE PE MITNO PLUMBER VAI I FY R0111 EVAgn Pi umamr. ca. RECEIVED BY READY FOR DATE ISSUED RI RST INSPECTION ADDRESS I/��TT� �f 27 BUILDING CITY TEL NO /11. 2'2719 ADDRESS COUNTY 0 93M Ex 1 ES 6 30-J' LOCALITY r NEAREST PERM FEES CROSS ST NYNEER TTP[01 FI1(TVRE OR ITEM FEE OWNER AIL WATER CLOSET TOILET O DO AD DR BATH TUB O DO CI�TEL NOEL NO SHOWER O 50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIP LAVATORY WASH BASIN Ono APPLICATION AND STATE THAT THE ABOVE Ip CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN BINK O 60 STATE LAWS REGULATING PLUMBING 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRYTUS OR TRAY O SO ANGELES COUNTY LICENSE OR 1 AM THE LEGAL OWNER OF THE RWIDENTI PROPERTY DESCRIBED ABOVE GAS SYSTE OUTLCM O 5 ' E WATER HEATER 050 SIGNATURE I[[ OF SLOP SINK Geo INSPECTION RECORD FLOOR BINK O 50 FLOOR DRAIN 050 DISHWASHER O 5o DRINKING FOUNTAIN O 50 URINAL Q O SO J HOUSESEWER 0 DO _Z MISCELLANEOUS 0 0 APPROVALS DATE INSI CTOR R NAME ROUGH PLUMBING -� GAS PIPING GAS VENT CESSPOOL 1 00 CESSPOOL SEPTIC TANK SEPTIC TANK DRAIN ( ) PIT ( ) @ 100 11 SEWER cr PERMIT 100 GAS.TEST UTILITY CO NOTIFIED TOTAL FEE E 0 FINAL ?MDDT IT D DO m APPLICATION FOR PEUCT DEPARTMENT OF BUMI)ING AND SAFETY L B' COUNTY OF LOS ANGELES WILLIAM J FOX CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO GROUPZONE PERMIT NO s geooz _ /9 PLUMBER VALLEY BOULEVARD PLUMBING RECEIVED BY READY FOR DATE ISSUED pp��ryT1�� A�^ `� FIRST INSPECTION G -�/ ADDRESS O`W EST VALLEY BLVD \ BUILDIna CITY Q.�QOSEMEAD reL GAT. 2-2719A oR[ee COUNTY LICENSE N sim KXPIRKS 6','Jf1' LOCALITY 1^ JVNEAREST PERM FEES CROSS Sr NYHmII TYPE Or FlZTU11[OR ITEM FEE OWNER MAIL WATER CLOSET TOILET 030 • ADDRESS BATH TUB O SO CI THL M SHOWER O DO I HERESY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY WASH BASIN) O SO APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK O DO STAT[ LAWS REGULATING PLUMBING I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRYT @ O SO ANGELES COUNTY LICENSE OR i AM THE LEGAL OWNER OF THE RESIDENTIA P PERTY DESCRIBED ABOVE GAB SYSTEM_OUTLDTS O DO SIGNATURE OF WATER HEATER O BO PERM] SLOPSINK a O BG INSPECTION RECORD FLOOR SINK O D FLOOR DRAIN O BO DISHWASHER O BO DRINKING FOUNTAIN O DO URINAL O DO -� HOUSESEWER O DO 0 MISCELLANEOUS I7 C O APPROVALS DATE IN[r[ROD NAM[ ROUGH PLUMBING GAB PIPING GAB VENT I CESSPOOL 1 00 B CESSPOOL SEPTIC TANK SSPrIC TANK DRAIN ( ) PIT ( ) 11 00 SEWER PERMIT 1 00 OAS TEST UTILITY CO NOTIFIED TOTAL FEE e O r FINAL � CITY OF TEMPLE CITY 76 A 667 — CE 617 768 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES B48666 DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION DING 9641 E. Val JOHN A LAMBIE COUNTY ENGINZER COLEMAN W JENKINS SUPT OP BUILDING LOCAL= Temple City FOR APPLICANT TO FILL IN PR NT O TYPE C„90s1�87 Lon CIOn & Temple C'it i NUMBER FIXTURE OR ITEM EACH FEE OWNER Suzanne A. Puhl WATER CLOSET 150 _ BATH TUB 1 50 DRESS Same SHOWER 1 50 CITY TEL NO LAVATORY 150 CONTRACTOR Genall m SINK 15o ADDRESS SM West Blvd. DISHWASHER 150 CIT! .a" �^ �m Tu NO PL E 2661 CLOTHES WASHER 1 50 SLIC TATE NO t/'1Er1 15im CLASS SWIMMING POOL RECEPTOR 1 50 DIRT�ONOy G P ON! PR LAWN SPRINKLER SYSTEM 2 00 J r [JJXX 1 WATER HEATER 150 1 50 WWARLR APPROVAL GAS SYSTEM OUTLETS 1 50 INSPECnoRRCORD OUTLETS OVER 30 Z�' dW 5 PER SYSTEMRmdy WAMM BDPZ NM 4 r �2 z Plan check fee 25% of above See reverse PLUMBING PERMIT ISSUING FEE E 2 00 TOTAL FEE 1 31 50 APPROVALS DATE INSPECTOR SEIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING GAS VENT City Tel No HOT WATER HEATER I NEwv ACKNOWLEOOE TNAT 1 HAV[ RUD THIS APPLICATION AND WAT[ THAT THE A V[ IO COIIIRR AND A6RQ TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND RAT[ LAWS MOULATING GAS TEST RUMSINO I HERlAY C[RTIPY THAT I AM Pw NLY MGI"KMD AND/Ow UTILITY CO NOTIFIED LICENUD Ae IRGUIRm By LGs AGcttS COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE ":AL OWNER OF AND INTEND TO RuIO[ IN TMc AYOVE DESCRIS[D 11ESIRl1/lTly.FIIO RrY FINAL SIGNATURE /V(p/(J� JACK R ALLEN, SUP RVI ING MECHANICAL ENG'R OF PERM ITTE! PERMIT VALHJATION(nm o CASH PLAN CHECK VALIDATION CK M D CASH �� I Crl; 8 5 2 3� FEB22 5 D 3.50~ c WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby off rm that I have a certificate of consent to self 76A007A insure or a certificate of Workers Compensation Insurance CE 817(REV 10/81) 1'orr o'certiffieed copy thereof (Sec 3800 Lob C ) /� COUNTY OF LOS ANGELES BUILDING AND SAFETY LQR'4 M16✓O9 I J Company 1�'�M,�r 1W.0 ❑ Certified copy Is hereby furnished FOR APPLICANT 70 FILL IN(PRIM OR TYPE) BUILDING V^, S Certified copy is filed with th county bu ding irllpeC ADDRESS Ffs� hon department NUMBER FIXTURE OR ITEM ® FEE �� ({/� �� tocAUTv L Date�LL�L4..ApphGcmt �� WATER CLOSET NEAREST /�L CERTIFICATE OF EXEMPTION WORKERS' BATH TUB COMPENSATION INSURANCE (This section need net be cortrpMlvOWNER leted If the ork Im,oed by SHOWER A.rLw u the permit is for ono hundred dollars($100)or less ) LAVATORY =L SS I certify that in the performance of the work for which this permit is Issued, I shall not employ any person in any manner I SINK D CITY TEL NO so as to become subject to the Workers'Compensation Lows DISHWASHER d CONTRACTOR kLk,►L. Alludsiv,44yo Date Applicant CLOTHES WASHER � NOTICE TO APPLICANT If after making this Certificate of AWRE55 N.)rlpvtm ' Exemption you should become subject to the Workers SWIMMING POOL RECEPTOR ,/yrs pfiz Compensation provisions of the Labor Code you must forth- CITY \_' Y /A TEL NO Z� ��• with comply with such provisions or this permit shall be LAWN SPRINKLER SYSTEM STATE y Beg LIC deemed revoked �� WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO� Y I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Busmess OUTLETS OVER and Professions Code,and my license is in full force and effect 5 PER SYSTEM FI VA ATION y License NumberLI69MS I tic Clow DATE 1A IL! 1A �lll� 4-Nod& S -i y Br 8 Contractor to ❑ O I am exempt under Sec � U B 8P C for this reason a. Plan check fee y Dote PLUMBING PERMIT ISSUING FEE$ SO ,Z. Signature } TOTAL FEE O Plan check applicant # 4 Q 4 SINGLE FAMILY I e e 2 B S O HOME OWNER BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractors License e • • 2 Q5 Low for the following reason (Section 7031 5 Business and Address � � 4-8 8 Professions Code) City Tel No 0 i ❑ I, as owner of the property will do the work and the , structure is not intended or offered for sole (Section 70" Business and Professions Code) CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for , the performance of the work for which this permit is issued r (Sec 3097 Gv C ) Lender s Nome P— Lender - Lender s Address I certify that I have read this application and state that the ► above information,s correct I agree to comply with all County ordinances and State laws regulating Plumbing and hereby authorize repreTentahves of this County to enter upon the ,b-h- menGf ection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE t ,—1 V::64 S,gno ure of Permittee Dote